myAvatar currently supports the configuration and billing of these new codes. These service codes will need to be configured as ‘Other’ Service Code Types. Detailed information on configuring these service codes is available on the WIKI under the ‘myAvatar Add-On Code Enhancements’ page.

myAvatar Accounts Receivable (AR) Console

In Q4 of 2018, Netsmart released the much-anticipated Accounts Receivable Console. It is now generally available for all clients using Avatar PM. The AR Console:

Allows organizations to create set work queues for AR staff based upon guarantors, programs and/or client’s initials

Allows AR staff to filter the outstanding receivables by various parameters, including the next follow-up date that is set as a tickler for staff

Allows AR staff to easily view outstanding AR for other staff members

Allows AR staff to set advanced filters to work specific denials

Allows staff to create a claim follow-up record for denials received on paper remittances

Allows AR staff to document claim follow-up notes

Allows AR Staff to mark claims for resubmission, automatically pulling in the Payer ICN from the 835

Allows users to copy claim follow-up notes to multiple claim follow-up records for other services for the same client. Doing so reduces entry of redundant claim follow-up notes

Allows users to view all follow-up notes for a given service that may have been distributed across multiple payers and documented by other users

Provides access to the Client Ledger for a specific service in one click

Provides access to the applicable Managed Care Authorization form in one click

Allows users to manually post payments, adjustments and transfers to a specific service on a claim

A configuration and training guide can be found on the WIKI for this new capability.

Pre-Requisites

The following existing myAvatar functionality should be configured for organizations to fully utilize all the capabilities included in the myAvatar AR Console.

If you need assistance with implementing these features or configuring the Accounts Receivable Console, you can contact your Client Alignment Executive for information on professional services.

For those organizations using CAL-PM, the AR Console is on the 2019 roadmap. We'll keep you posted on when that will be available.

myAvatar MSO Claims Pre-Adjudication

In Q4 of 2018, Netsmart released enhancements to myAvatar MSO and ProviderConnect to add functionality to pre-adjudicate potential claims. ProviderConnect users can now create treatment services and submit them to myAvatar MSO for pre-adjudication.

myAvatar MSO will accept these services and evaluate them against the organization’s adjudication rules. ProviderConnect users will receive a response and determine whether the treatment services would be accepted and paid or denied if submitted.

ProviderConnect users will then be able to edit these services prior to generating claims.

These enhancements give external providers who utilize ProviderConnect greater visibility and access to make edits to their services prior to claim submission. A successful implementation of this feature should result in an increased number of approved claims upon firs- time submission to myAvatar MSO from ProviderConnect users.